Journal of Pediatric infectious diseases最新文献

Objective The incidence of syphilis and congenital syphilis has increased in recent years according to European and United States of America official data: indeed, 2019 was the second consecutive year when the number of reported cases has increased. Syphilis is a venereal disease caused by a spirochete, Treponema pallidum. Congenital syphilis is a consequence of maternal T. palidum transmission to a fetus at any stage of maternal disease, via a transplacental pathway or during labor.

Methods To investigate the incidence, characteristics, and temporal evolution of neonates with suspected congenital syphilis (proven, possible, or less likely and unlikely) or born from mothers with treated and untreated latent syphilis, we designed a retrospective and descriptive study of hospitalized neonates between 2001 and 2020, in a level II hospital located in the northern Portuguese countryside.

Results We report a total of 22 neonates, 50% female. Pregnancy was unsupervised or had inadequate surveillance in 36% of cases (n = 8), in 32% (n = 7) syphilis was not treated, and in 14% (n = 3) it was inadequately treated. All neonates studied with suspected congenital syphilis were asymptomatic and all were treated with penicillin for a mean duration of 11 days. Of the 22 neonates with suspected congenital syphilis, 20 had possible congenital infection. Social vulnerability was also an important factor present in our study group.

Conclusion Despite being an ancient disease, congenital syphilis is still a concern mostly due to the lack of adequate pregnancy surveillance and maternal/partner diagnosis and treatment.

Objective Since vaccination for coronavirus disease 2019 (COVID-19) has been initiated, rare cases of COVID-19 mRNA vaccination-associated myocarditis (VAM) have been reported worldwide. This study aimed to report the short-term outcomes and the clinical presentation of VAM in South Korean adolescents.

Methods In this prospective multicenter study across five tertiary hospitals in South Korea, patients aged 12 to 17 years with symptoms of VAM were included from October 18, 2021, to April 30, 2022. We performed laboratory tests, electrocardiography, chest radiography, echocardiography, and cardiac magnetic resonance imaging studies on these patients.

Results A total of 14 patients were diagnosed with VAM during the study period. The median age of the patients was 15.2 years (interquartile range [IQR], 14.6–15.9) and 11 patients (78.6%) were male. All patients had received a messenger RNA Pfizer-BioNTech COVID-19 vaccine. The median latent period from vaccination to symptom onset was 1 (range, 0–8; IQR, 0.8–3.5) day. Chest pain was the most common symptom (11/14, 78.6%), and the median duration of symptoms was 1 week. Except for one patient (7.1%) who was admitted to intensive care unit, most patients (13/14, 93.8%) had a minor and short clinical course without an intensive treatment including an immune modulator.

Conclusion VAM in South Korean adolescents had self-limiting clinical courses as reported by previous studies. Despite the small number of cases, our findings, consistent with previous studies, revealed that East Asian adolescents might have a similar or even milder clinical course than adolescents of other ethnicities.

Objective Severe acute respiratory syndrome coronavirus 2 is a highly contagious respiratory viral infection that affects all individuals, although neonates are considered to be the most susceptible populations; therefore, this study was conducted to evaluate the clinical outcome and association between coronavirus disease 2019 (COVID-19)-positive mothers and newborns.

Methods This cross-sectional study was conducted at a dedicated COVID-19 tertiary care hospital in India over a period of 1 year. The pregnant mothers infected with COVID-19 virus were enrolled with their newborn baby up to the age of 28 days. COVID-19 test was done by using a rapid antigen kit and further confirmed by reverse-transcription polymerase chain reaction.

Results Prevalence of COVID-19-positive newborns born of COVID-19-positive mothers is reported at 8.4%. Female:male ratio was found to be 1:1.2. Raised D-dimer (88.9%) and C-reactive protein (88.9%) were the most common findings in COVID-19-positive newborns followed by leucopenia (33.3%). Among the COVID-19 newborns, Apgar score less than or equal to 7 and respiratory distress were found in 55.6 and 33.3%, respectively. Out of 9 COVID-19-positive newborns, two (22.2%) were expired, and out of 98 COVID-19-negative newborns, 4(4.1%) were expired.

Conclusion This study revealed that severity of maternal symptoms is related to mortality of newborns. About 22.2% COVID-19-positive newborns expired, whereas 4.1% of COVID-19-negative newborns expired so risk of mortality increased among COVID-19-positive neonates as compared with negative ones. However, this study was conducted on a small sample size and further research with larger populations is needed to validate these findings.

Objective This article investigates the frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity and its association with the severity of new-onset acute ischemic stroke (AIS) among previously healthy children with asymptomatic/mild coronavirus disease 2019 (COVID-19).

Methods A case–control study that included children < 18 years with out-of-hospital AIS of undetermined etiology and a control group of healthy children. Exclusion criteria were current respiratory symptoms, previous COVID-19 diagnosis, prior COVID-19 vaccination, active SARS-CoV-2 infection, history of hospital admission in the last 6 months, and having a stroke predisposition. We screened children for SARS-CoV-2 immunoglobulin G antibodies using enzyme-linked immunosorbent assay. The severity of stroke was evaluated using the Pediatric National Institutes of Health Stroke Scale (PedNIHSS).

Results The current study included 25 children (15 males and 10 females; median age 24 months) with out-of-hospital AIS and 25 healthy controls (11 males and 14 females; median age 24 months). SARS-CoV-2 seropositivity was detected in 15 (60%) of AIS children and 11 (44%) among controls (p = 0.258). Compared with seronegative AIS children, those seropositive for SARS-CoV-2 had higher PedNIHSS scores (median 19 vs. 8.5; p = 0.001), pediatric intensive care unit admission (93.3% vs. 40%; p = 0.007), need for mechanical ventilation (53.3% vs. 10%; p = 0.040), and D-dimer levels (median 3.5 vs. 1.75 μg/mL; p < 0.001).

Conclusion SARS-CoV-2 seropositivity may be associated with more severe AIS affecting previously healthy children during the postacute phase of asymptomatic/mildly symptomatic COVID-19.

Objective The objectives are to characterize the distinct clinical profiles of respiratory syncytial virus (RSV) and parainfluenza virus (PIV) infections and how these profiles shift with the addition of bacterial coinfections.

Methods This retrospective study analyzed data from more than 1,000 hospitalized children to compare RSV monoinfection with PIV monoinfection, as well as RSV/PIV coinfection with bacteria with monoinfection.

Results Significant differences in age distribution (p < 0.001), clinical presentation (p < 0.001), the proportion of pneumonia (p < 0.001), mechanical ventilation (p = 0.004), pediatric intensive care unit (PICU) admission (p = 0.001), and duration of hospitalization (p = 0.003) were observed between RSV and PIV monoinfections. Children with bacterial coinfections had a higher proportion of cough (p = 0.004), wheezing (p = 0.003), rales (p = 0.002), pneumonia (p = 0.002), and PICU admission (p = 0.021) than PIV monoinfection. Notably, the duration of hospitalization for children with bacterial coinfections was longer than that of those infected with a single PIV infection, with a statistically significant difference (p = 0.028).

Conclusion Compared with PIV, RSV was more likely to cause severe respiratory tract infections. Coinfection of PIV with bacteria may have exacerbated the severity of acute respiratory tract infections and worsened the symptoms.